Alcohol-related problems have been found to be over-represented among patients seen in some primary care settings compared to the general population. Rates of heavy alcohol use and alcohol-related problems have also been found to vary by region of the country, as well as within the same geographic locality depending upon the type of facility and demographic characteristics of clientele served. Alcohol abuse and alcohol dependence are an ever increasing burden to society, totaling an estimated $85.8 billion in 1988. It is also estimated that over 500,000 outpatient visits are made each year for alcohol-related problems, and many of these individuals are seen in primary care settings. Identification of those who could benefit from a brief intervention in primary care settings is important for early intervention and prevention of alcohol-related problems. Little information is available, however, on the most efficient screening methods for identifying problem drinkers in primary care settings, particularly among women and ethnic minorities. The general aims of this project are two: 1) to further explore the over- representation of alcohol-related problems in primary care settings by comparing patients seen in primary care clinics to those seen for non- injury problems in the emergency room (ER) in the same geographic location, to those seen in primary care settings in another region of the country, and to the general population; and, 2) to determine the most efficient screener for identifying those in primary care settings who may benefit from a brief intervention for alcohol-related problems. The project extends work currently funded under both the Alcohol Research Group's Center grant and separate R01 funding. The project involves new data collection in two primary care clinics in Jackson and Hinds County, Mississippi (N=1,048), and comparisons of these data with similar data already collected from the University of mississippi Medical Center ER in Jackson, and from the 5 county-operated primary care clinics and 3 Kaiser Permanente urgent care clinics in Contra Costa County, California. Data on drinking patterns, alcohol-related problems and alcohol dependence from the proposed project will also be compared to data which will be collected in the 1995 National Alcohol Survey (under present center funding) and to data from a new general population survey of Contra Costa County, CA, to be collected in 1995 under separate funding.